Resources Repository
-
ArticlePublication 2014'Big Push' To Reduce Maternal Mortality in Uganda and Zambia
In the past decade, “big push” global health initiatives financed by international donors have aimed …
In the past decade, “big push” global health initiatives financed by international donors have aimed to rapidly reach ambitious health targets in low-income countries. The health system impacts of these efforts are infrequently assessed. Saving Mothers, Giving Life is a global public-private partnership that aims to reduce maternal mortality dramatically in one year in eight districts from Uganda and Zambia. The authors evaluate the first six to twelve months of the program’s implementation, its ownership…
Health Outcomes | Health Systems | Government/Law | Health/Medicine | Sub-Saharan Africa -
ArticlePublication 2014Rise and Fall of HIV in High-Prevalence Countries: A Challenge for Mathematical Modeling
Several countries with generalized, high-prevalence HIV epidemics, mostly in sub-Saharan Africa, have experienced rapid declines …
Several countries with generalized, high-prevalence HIV epidemics, mostly in sub-Saharan Africa, have experienced rapid declines in transmission. These HIV epidemics, often with rapid onsets, have generally been attributed to a combination of factors related to high-risk sexual behavior. The subsequent declines in these countries began prior to widespread therapy or implementation of any other major biomedical prevention. This change has been construed as evidence of behavior change, often on the basis of mathematical models, but…
Health Outcomes | Mathematical Models | Infectious Diseases | Health/Medicine | Sub-Saharan Africa -
ReviewPublication 2014Markov Modeling & Discrete Event Simulation in Health Care: Systematic Comparison
This review assesses whether the use of Markov modeling (MM) or discrete event simulation (DES) …
This review assesses whether the use of Markov modeling (MM) or discrete event simulation (DES) for cost-effectiveness analysis (CEA) may alter healthcare resource allocation decisions. A systematic literature search and review of empirical and non-empirical studies comparing MM and DES techniques used in the CEA of healthcare technologies was conducted. The primary advantages described for DES over MM were the ability to model queuing for limited resources, capture individual patient histories, accommodate complexity and uncertainty,…
Microsimulation | Mathematical Models | State-Transition | Health Systems | Clinical Care | Health/Medicine -
ArticlePublication 2013Validation and Calibration of a Simulation Model of Pediatric HIV Infection
The authors developed a microsimulation model of pediatric HIV disease progression using the Cost-Effectiveness of …
The authors developed a microsimulation model of pediatric HIV disease progression using the Cost-Effectiveness of Preventing AIDS Complications (CEPAC) model framework. This CEPAC-Pediatric model was then validated by varying CD4 data and comparing the corresponding model-generated survival curves to empirical survival curves obtained from the International Epidemiologic Database to Evaluate AIDS (IeDEA). The model was calibrated to other African countries by systematically varying immunologic and HIV mortality-related input parameters. In the calibration analyses, the model-generated…
Microsimulation | Calibration/Validation | Infectious Diseases | Child/Nutrition | Health/Medicine | Sub-Saharan Africa -
ArticlePublication 2013Contribution of H. Pylori and Smoking to US Incidence of Gastric Adenocarcinoma: A Microsimulation Model
Although gastric cancer has declined dramatically in the US, the disease remains the second leading …
Although gastric cancer has declined dramatically in the US, the disease remains the second leading cause of cancer mortality worldwide. This analysis estimates the contribution of risk factor trends on past and future intestinal-type non-cardia gastric adenocarcinoma (NCGA) incidence. The authors developed a population-based microsimulation model of intestinal-type NCGA and calibrated it to U.S. epidemiologic data on precancerous lesions and cancer. The model explicitly incorporated the impact of Helicobacter pylori and smoking on disease natural history, for which…
Microsimulation | Calibration/Validation | Chronic Disease/Risk | Social Determinants | Culture/Society | Health/Medicine | North America -
ArticlePublication 2013Health Benefits and Cost-Effectiveness of Strategies to Reduce Maternal Mortality in Afghanistan
This article, published in Health Policy and Planning, disaggregates data on pregnancies in Afghanistan to …
This article, published in Health Policy and Planning, disaggregates data on pregnancies in Afghanistan to evaluate health outcomes and cost-effectiveness of interventions related to childbirth. These interventions include antenatal care, family planning, skilled birth attendance, access to transport, referral facilities, and quality of overall care. Outcomes include pregnancy-related complications, maternal deaths, maternal mortality ratios, costs and cost-effectiveness ratios. The authors report that increasing family planning would be the most effective individual intervention. The model suggests…
Health Outcomes | State-Transition | Cost-Effectiveness Analysis | Maternal/Reproductive Health | Health Systems | Policy/Regulation | Economics/Finance | Health/Medicine | Asia & Pacific -
ArticlePublication 2013Public Finance of Rotavirus Vaccination in India and Ethiopia: Extended CEA
This study uses extended cost-effectiveness analysis (ECEA) to evaluate a hypothetical publicly financed program for …
This study uses extended cost-effectiveness analysis (ECEA) to evaluate a hypothetical publicly financed program for rotavirus vaccination in India and Ethiopia. The authors measured program impact on: (1) averted rotavirus deaths; (2) reduction in household expenditures; (3) financial risk protection; and (4) distributional consequences across the country’s wealth strata. In India and Ethiopia, the program was predicted to decrease rotavirus deaths substantially, and effectively provide financial risk protection among the poor, while also reducing household…
Health Outcomes | Priority Setting/Ethics | Cost-Effectiveness Analysis | Infectious Diseases | Child/Nutrition | Social Determinants | Culture/Society | Economics/Finance | Health/Medicine | Sub-Saharan Africa | Asia & Pacific -
ArticlePublication 2012Value of Family Planning for Improving Maternal Health in Rural Afghanistan
This article, published in the Afghanistan Journal of Public Health, uses a model designed to …
This article, published in the Afghanistan Journal of Public Health, uses a model designed to simulate the natural history of pregnancy and associated maternal mortality and morbidity contextualized to Afghanistan to assess the cost-effectiveness of family planning in the rural Maywand district of Kandahar. Using total fertility rate, pregnancy-related complications, maternal mortality ratio, lifetime risk of maternal death, and proportionate mortality ratio as outcomes, the model finds that increasing family planning from 8% to 30-50% could…
Health Outcomes | Cost-Effectiveness Analysis | Maternal/Reproductive Health | Policy/Regulation | Health/Medicine | Asia & Pacific -
ArticlePublication 2012Health and Economic Outcomes of Interventions to Reduce Pregnancy-Related Mortality in Nigeria
This paper examines the cost-effectiveness and impact of individual and integrated packages of interventions aimed …
This paper examines the cost-effectiveness and impact of individual and integrated packages of interventions aimed to reduce maternal mortality in Nigeria, a country with extremely high maternal mortality rates. Using a previously validated model adapted to the Nigerian context, the study finds that an increase of access to family planning is the most effective individual strategy, which not only reduces pregnancy-related mortality but also proves to be economically efficient. However, relying solely on family planning…
Health Outcomes | State-Transition | Cost-Effectiveness Analysis | Maternal/Reproductive Health | Health Systems | Policy/Regulation | Economics/Finance | Health/Medicine | Sub-Saharan Africa